The use of dental composites for the creation and restoration of dental aesthetics in any corrective treatments,

has many advantages. They are easily applied, without the need for any significant invasive procedures or any extensive loss of natural tooth structure, and they can be easily bonded to sound teeth. They can prove to be the best treatment option where minor aesthetic work is required and can negate the need to make a full veneer.

It should be remembered that any corrective treatments must seek to maintain good aesthetics. The patient’s appearance must not be compromised by any overbuilding of composite, and the material should not be used to simply fill up a black triangular space!

Although dental composite has been shown to be an ideal restorative material, the use of conventional metal or mylar matrix strips can create problems for the practitioner. These matrix types do not possess the ideal properties of flexibility or adaptation that will allow the practitioner to create a properly contoured shell within which any corrective composite material can be successfully placed. They can be uncomfortable for the patient, and bleeding may result from the use of

Using conventional metal or mylar matrix strips can sometimes cause problems when moulding composite, but Dr David Clark’s innovative matrix system can help create successful aesthetic results

PPDinnovaTions

To ask a question or comment on this article please send an email to: PPD@fmc.co.uk

ppd

28 November 2012 PPD

For further information about Clarkmatrix, please contact UK distributor Optident Ltd on 01943 605 050 or visit www.optident.co.ukClarkmatrix and its related products are known as Bioclear in the US

retaining wedges, which can sometimes result in contamination of bonding resins, and may ultimately result in bond failure.

The maTrix TechniqueThe Clarkmatrix system was developed by Dr David Clark, an American dental practitioner based in Washington. His extensive research in attempting to overcome the problems associated with the aesthetic correction of ‘black triangle’ disease, led him to develop the Clarkmatrix.

The matrices are formed from an ultra-thin pliable plastic material (mylar, 50 microns), and are anatomically contoured, having a defined shoulder that can be easily filled with dental composite. The contour allows the creation of a more natural emergence profile, which will in turn help to improve the appearance of the interdental papillae.

The use of conventional strip matrices and poor or incorrect placing of composite resin can contribute to unacceptable aesthetics, but use of the Clarkmatrix system can be instrumental in helping the practitioner achieve a much better anatomical tooth form. Their design is such that two matrices can be placed side by side to aid symmetry when

adding composite to two adjacent teeth. Their clever design also enables them to stay in place whilst composite resin is applied.

In carrying out any corrective procedures, Dr Clark recommends that a thorough prophylaxis of the teeth should be undertaken prior to any material application. He also suggests that a plaque disclosing solution then be applied to help highlight any biofilm, stains or cement that must be removed

The nexT big Thing?the CLarKmatrix SyStem

before using the Clarkmatrix system. An air abrasive method, such as the EMS Air Flow (Optident Ltd) will prove to be effective for this.

After placement of the Clarkmatrix, an explorer can be used to pull back the flexible wall of the matrix, followed by careful application of an etching gel, (eg Ultra Etch, Optident Ltd), making sure that it can reach the gingival margin areas. Following placement of an appropriate bonding resin, the use of a flowable composite resin is advocated, which can then be injected under the flexible matrix forms. This can be followed by the injection of paste composite into the uncured pool of flowable composite resin. The paste composite will be more readily adapted if heated, and Dr Clark also advises that after etching, the bonding resin and composite layers be cured in one operation, with no need to cure these layers individually, thus saving valuable time.

Any excess bonding resin or composite can be removed with a dry brush, and following removal of the Clarkmatrix, finishing can be completed using a ‘Brownie’ or similar point at a medium speed, with water spray to prevent overheating of the composite.

The Clarkmatrix system can now satisfy the dental practitioner’s requirements by providing a practical solution to the problem of ‘black triangle’ correction, diastema closure and peg laterals, of which full clinical treatments can be seen in PPD September (page 85), October (page 98) and November (page 84) respectively.

Before and after views of black triangle treatment using Clarkmatrix

the Clarkmatrix design is such that two matrices can be placed side by side to aid symmetry when adding composite to two adjacent teeth

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